Wednesday, March 31, 2010

Hospitals Eligible for Medical Resident Tax Refunds Filed before April 1, 2005

According to an IRS announcement, institutions that filed FICA tax refund claims for medical residents in tax years ending before April 1, 2005 will be granted their claims, despite the current policy which bars the refunds.

Prior to April 1, 2005, residents qualified for "student" status tax exemption for services performed "incident to and for the purpose of pursuing a course of study." However, this exemption did not apply to residents, who were considered "full-time employees," and they were subject to a a FICA employment tax on their wages. Several teaching hospitals had challenged their rejected claims in appellate court, with some courts granting the claims, and others siding with the IRS.

The current Treasury Regulations, which went into effect on April 1, 2005, treat medical residents as full-time employees subject to the FICA tax, and ineligible for refunds. The IRS' announcement states that those teaching hospitals that filed claims for their residents prior to the April 1, 2005 regulation will be contacted by the IRS with steps on how to obtain their refunds.

Source: Drinker Biddle & Reath LLP

Friday, March 26, 2010

Harvard Professor Expected to Be Named New Head of CMS

Donald M. Berwick, MD, MPP, FRCP is expected to be named the new Administrator for the Centers of Medicare & Medicaid Services (CMS) next week. Berwick is currently a professor of Health Policy and Management at the Harvard School of Public Health.

Berwick also serves as the President and CEO of the Institute for Healthcare Improvement, a non-profit organization focused on improving patient care worldwide. He is also a Clinical Professor of Pediatrics and Health Care Policy at the Harvard Medical School, an Associate in Pediatrics at Boston’s Children’s Hospital, and a Consultant in Pediatrics at Massachusetts General Hospital.

Charlene M. Frizzera is currently serves as the Acting Administrator of CMS. CMS' last permanent administrator was Mark McClellan, who left the agency in 2006.

Source: BNA

Wednesday, March 24, 2010

President Obama Signs Health Reform into Law

Yesterday, President Obama signed HR 3590, "The Patient Protection and Affordable Care Act" into law. The Senate-created bill was passed by the House late Sunday night by a vote of 219 to 212. 37 Democrats joined all 178 Republicans in opposing the healthcare overhaul plan.

Although Congress has essentially completed health reform, there is still one more vote that can affect the final package. The Senate will vote on HR 4872, the House's reconciliation bill this week, which proposes amendments to HR 3590 to include some of the provisions that were included in the House's original proposal, but eliminated in the Senate bill that passed in the House on Sunday.

NAMSS has provided a summary of the major provisions included in the final health reform plan. Most of the changes affect changes to the payment system and do not have a direct impact on the daily work of MSPs. However, now that health reform has passed in Congress, there is still much work to be done by the federal agencies in order to put the rules and regulations of health reform into place. The quality-focused and workforce planning initiatives assigned to the Secretary of Health and Human Services could have an impact on the work of MSPs.

To read the summary, click here:

Tuesday, March 16, 2010

Physician Groups Object to NP Prescription Authority

Several physician groups such as the American Medical Association (AMA) and Kentucky Medical Association are speaking out in opposition of expanded medical authority to nurse practitioners. Nurse practitioners currently hold independent prescribing authority in 12 states, while 29 states allow them to prescribe under physician supervision.

The increased authority of nurse practitioners has been used as a way to increase access to primary care services. In some states, nurse practitioners have been able to carry out primary care functions, such as performing routine examinations, prescribing controlled substances, and signing off on immunization records.

The physician groups are opposed to efforts in four states to grant nurse practitioners prescribing authority. They are also opposed to efforts to eliminate physician supervision of nurse practitioners. They believe that the training program for nurse practitioners does not adequately prepare them to carry out the tasks of physicians.

Source: USA Today

Monday, March 15, 2010

TJC Board of Commissioners Approves MS.01.01.01

Chuck Mowll, Executive Vice President of Business Development and Government and External Relations, has announced that The Joint Commissioner's (TJC) Board of Commissioners has approved the Task Force revision of MS.01.01.01 (formerly MS.1.20) for implementation.

MS.01.01.01 will be effective beginning March 31, 2011. TJC will be releasing educational documents in the next few days to help facilities understand the standard and how to implement it. There are also plans to hold an audioconference in April, which will allow participants to ask TJC staff specific implementation questions.

Mr. Mowll reported mostly positive feedback from TJC's field review, which ended earlier this year. 66 percent of respondents thought that the Task Force's revision was a positive improvement, 4 percent thought it was worse, and the remaining respondents wanted more clarification.

NAMSS thanks Task Force representative and Past President Carol Ostermann for representing the views of MSPs in order to achieve a better version of this standard, as well as all members who participated in the various field reviews. NAMSS will also be providing education on MS.01.01.01 in addition to the offerings from TJC. These will be posted on the NAMSS homepage at as they become available.

To view the standards and FAQs, click here:

Thursday, March 11, 2010

NY Dept. of Labor to Promote Fair Labor Standards in Health Care Industry

The New York Department of Labor has announced that it will focus on the promotion of the Fair Labor Standards Act (FLSA) in healthcare professions, after 65% of healthcare employers investigated last year were found to be in non-compliance with the act.

The following article by Epstein Becker & Green provides an example of the laws, which concern pay guidelines such as overtime pay and mealtime compensation.

Employers are encouraged to perform audits to ensure that employees are being compensated under the correct wage classifications. Your HR department can help you determine the guidelines that apply to your job.

To read the full article, click here:

Source: Epstein Becker & Green

Wednesday, March 10, 2010

ABP Provides Clarification on Provider Status Reporting

The American Board of Pediatrics (ABP) has provided clarification on how to credential diplomates now that they have implemented their Maintenance of Certification (MOC) program and will no longer issue certificates with specific end dates.

The ABP recommends entering January 1, 2010 as the re-verification date for all diplomates enrolled during 2009.

A memorandum with the guidance, along with a letter that was sent to diplomates can be found here:

Monday, March 8, 2010

Wyoming Case Highlights Issue of Informed Consent

In a narrow holding, the US Court of Appeals for the Tenth Circuit held that a patient has a valid informed consent claim against a physician if the physician untruthfully answers questions from the patient regarding facts about his or her credentials that can be verified through factual information.

Marcy Willis relied on the claim of Dr. D. Scott Bender, who assured her that he could perform the removal of her gallbladder laparoscopically despite recommendations by her physician that abdominal surgeries be performed on her through an open procedure. Willis had questioned Bender on his success with performing the laparascopic procedure, and Bender answered that he had never been sued, and that he had consulted with her physician, who agreed to the procedure. Both answers turned out to be false, and Willis sued Bender after suffering complications resulting from the procedure.

The court ruled that under Wyoming's informed consent laws, a physician does not have an "affirmative duty to voluntarily disclose physician-specific information or to obtain the approval of a patient's regular physician prior to obtaining consent;" however it "would allow an informed consent claim where a physician lies to a patient as to physician-specific information in direct response to a patient's questions concerning the same in the course of obtaining the patient's judgment as to the quality of his performance or abilities."

This article serves as a reminder to MSPs that while you can't control what a physicians say to patients, it is important to make sure that they have an understanding of informed consent policies.

Source: BNA

Friday, March 5, 2010

HRSA Replaces Data Bank Management

The Health Resources and Services Administration (HRSA) has confirmed the reassignment of the management team in charge of the Division of Practitioner Data Banks (DPDB), which is in charge of the NPDB and HIPDB reporting systems.

The reassignments come after a report by ProPublica, an independent, nonprofit investigative group revealed inadequate reporting to the databanks by 20 states. This report surfaced as the section 1921 expansion became effective, which requires states to report adverse licensure sanctions.

Darryl Gray, Director of DPDB, has been replaced by Mark Pincus, who served as the program's director prior to Gray's term.

While HRSA recognizes that the databank may have gaps, they still encourage entities to query the NPDB for sanctions, especially now that private healthcare entities have access to sanctions for all licensed healthcare providers under section 1921. HRSA is working with the states to strengthen the information in the NPDB, and announced that states that inadequately report to the system will be publicized in July 2010.

Source: Los Angeles Times,0,2139660.story

New York Medicaid Adopts CAQH UPD

CAQH has announced that the New York State Department of Health, Office of Health Insurance Programs has adopted the Universal Provider Datasource (UPD) for the electronic collection of provider data for the state's Medicaid program.

The UPD is an online service that stores provider data for credentialing, claims processing, and other purposes. The system is designed to reduce the administrative burden for providers and healthcare entities.

"We are pleased that New York Medicaid has selected the Universal Provider Datasource to supplement its program administration," said Robin Thomashauer, executive director of CAQH. "The UPD is valued by providers, health plans and hospitals nationwide as a tool for reducing the time and expense associated with network enrollment."

For the full press release, click here:

Source: CAQH

Thursday, March 4, 2010

OIG Report Evaluates Adverse Event Reporting Methods in Hospitals

A report by the Department of Health and Human Services Office of Inspector General (HHS OIG) finds that reviewing medical records made by nurses and physicians may be the most effective way to monitor the occurrence of adverse events in hospitals.

The report, titled Adverse Events in Hospitals: Methods for Identifying Events, implemented five screening methods to a random sample of 278 Medicare beneficiary hospitals over a 2-week period in 2008. The case study was performed in accordance with the Tax Relief and Health Care Act of 2006, which requires OIG to publish regular reports on efforts to better identify adverse medical events.

The five methods employed in the case study were:
  • Nurse reviews of medical records;
  • Interviews of Medicare beneficiaries;
  • Two types of billing data analysis;
  • and Reviews of internal hospital incident reports.

Each flagged event identified using one of the above methods was later reviewed by physicians. OIG determined that the most effective screening method was the nurse review, which identified the most adverse events.

OIG has recommended that the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ) continue to research methods for identifying adverse events in the review of medical records.

To read the full report, click here: